The impact of dyspnea and threat of dyspnea on error processing

Abstract

Dyspnea (breathlessness) is a threatening and aversive bodily sensation and a major symptom of various diseases. It has been suggested to impair several aspects of functioning in affected patients, but experimental proof for this assumption is widely absent. Error processing is an important domain of functioning and has intensively been studied using electrophysiological measures. Specifically, the error-related negativity (ERN) has been suggested to reflect early performance monitoring and error detection, while the error positivity (Pe) has been linked to subsequent error awareness. So far, little is known about the effects of anticipated or perceived dyspnea on error processing. Therefore, in 49 healthy participants, we studied the effects of experimentally induced dyspnea and threat of dyspnea on the ERN/Pe and behavioral task performance. Participants performed the arrowhead version of the flanker task during three experimental conditions: an unloaded baseline condition, a dyspnea condition, and a threat of dyspnea condition. Dyspnea was induced by breathing through inspiratory resistive loads, while high-density EEG was continuously measured. No differences in task performance (reaction times, error rates) and ERN mean amplitudes were found between conditions. However, mean amplitudes for the Pe differed between conditions with smaller Pe amplitudes during threat of dyspnea compared to baseline and dyspnea conditions, with the latter two conditions showing no difference. These results may suggest that threat of dyspnea, but not dyspnea itself, reduces error awareness, while both seem to have no impact on early error processing and related behavioral performance.

The load of dyspnoea on brain and legs

“…Nevertheless, the present findings by LAWI et al [32], together with those from previous studies [24][25][26][27][28][29][30][31], have several important implications. First, they highlight that dyspnoea per se changes important higher brain processes, above the level of the brainstem respiratory oscillator required for normal and usually unconscious breathing.…”

“…Although not directly measured by LAWI et al [32], several previous studies using different neuroimaging techniques have already demonstrated that experimentally induced dyspnoea activates brain networks, which are also involved in cognitive, affective and motor processing [40][41][42]. These activations during acute dyspnoea, especially if involving brain areas that are needed for both processing of dyspnoea as well as cognitive and motor functions, limit available brain processing capacities for simultaneous cognitive and locomotor performance [26,29,30]. This dyspnoea-cognition/locomotor interference is in line with previous findings on dual-task interference showing that the simultaneous engagement in two tasks diminishes performance in both tasks, especially when depending on shared brain networks [43,44].…”

“…Similarly, SUCEC et al [27,28] recently demonstrated that resistive load-induced dyspnoea impairs response inhibition and recognition memory [29]. Even the anticipation of upcoming dyspnoea was suggested to affect such cognitive processes [30,31]. However, so far, the potential effects of acute experimental dyspnoea on other important domains of cognitive functioning, including locomotor performance, remain widely unknown.…”

Neuropsychological stratification of Chronic Obstructive Pulmonary Disease: building affect into clinically relevant neuro-biomarkers of breathlessness

“…The copyright holder for this preprint this version posted September 23, 2019. . https://doi.org/10.1101/19006684 doi: medRxiv preprint colleagues suggest that the threat of breathlessness may affect attentional processing by absorbing the available resources [20]. We assessed whether these findings could be replicated within the COPD population using an emotional Stroop task.…”

High cognitive load may prevent the development of nociceptive hypersensitivity

“…Sixty-four healthy participants were enrolled; four stopped during the sensitization procedure due to unbearable pain (two in experiment 1 and 2 in experiment 2). The final sample was composed of sixty participants: Twenty took part in experiment 1, (14 women, 6 men; median age 22 years, range 19-37), 19 in experiment 2 (15 women, 4 men; median age 22 years, range 18-40), 20 in experiment 3 (10 women, 11 men; median age 26, range [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36]. None of the participants took part in more than one experiment.…”